Hope Springs at Minnetonka

FHave a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.

Potential for more than minimal harm · Nursing and Physician Services Deficiencies · Tag F0727 · Deficient, Provider has date of correction (Apr 4, 2025)

FProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0812 · Deficient, Provider has date of correction (Apr 28, 2025)

FHave a plan that describes the process for conducting QAPI and QAA activities.

Potential for more than minimal harm · Administration Deficiencies · Tag F0865 · Deficient, Provider has date of correction (Apr 4, 2025)

FSet up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.

Potential for more than minimal harm · Administration Deficiencies · Tag F0867 · Deficient, Provider has date of correction (Apr 4, 2025)

FHave the Quality Assessment and Assurance group have the required members and meet at least quarterly

Potential for more than minimal harm · Administration Deficiencies · Tag F0868 · Deficient, Provider has date of correction (Apr 4, 2025)

EEnsure each resident receives an accurate assessment.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0641 · Deficient, Provider has date of correction (Apr 4, 2025)

DAllow residents to self-administer drugs if determined clinically appropriate.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0554 · Deficient, Provider has date of correction (May 1, 2025)

DHonor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0561 · Deficient, Provider has date of correction (Apr 25, 2025)

DHonor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0578 · Deficient, Provider has date of correction (May 1, 2025)

DHonor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0584 · Deficient, Provider has date of correction (May 6, 2025)

DProvide appropriate treatment and care according to orders, resident’s preferences and goals.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0684 · Deficient, Provider has date of correction (Apr 25, 2025)

DEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0689 · Deficient, Provider has date of correction (May 1, 2025)

DProvide safe, appropriate pain management for a resident who requires such services.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0697 · Deficient, Provider has date of correction (May 1, 2025)

DTry different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0700 · Deficient, Provider has date of correction (Apr 25, 2025)

DImplement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0758 · Deficient, Provider has date of correction (Apr 4, 2025)

DEnsure each resident receives and the facility provides food prepared in a form designed to meet individual needs.

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0805 · Deficient, Provider has date of correction (May 5, 2025)

FEnsure residents have reasonable access to and privacy in their use of communication methods.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0576 · Deficient, Provider has date of correction (Jun 12, 2024)

FHave a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.

Potential for more than minimal harm · Nursing and Physician Services Deficiencies · Tag F0727 · Deficient, Provider has date of correction (Jun 10, 2024)

FProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0812 · Deficient, Provider has date of correction (Jun 10, 2024)

FElectronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.

Potential for more than minimal harm · Administration Deficiencies · Tag F0851 · Deficient, Provider has date of correction (Jun 30, 2024)

FHave a plan that describes the process for conducting QAPI and QAA activities.

Potential for more than minimal harm · Administration Deficiencies · Tag F0865 · Deficient, Provider has date of correction (Jul 31, 2024)

FProvide and implement an infection prevention and control program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0880 · Deficient, Provider has date of correction (Jun 30, 2024)

FInclude as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0945 · Deficient, Provider has date of correction (Jun 30, 2024)

EHonor the resident's right to organize and participate in resident/family groups in the facility.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0565 · Deficient, Provider has date of correction (Jun 30, 2024)

EHonor the resident's right to manage his or her financial affairs.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0567 · Deficient, Provider has date of correction (Jun 19, 2024)

DDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0656 · Deficient, Provider has date of correction (Jul 1, 2024)

DProvide appropriate care/assistance for a resident with a prosthesis.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0696 · Deficient, Provider has date of correction (Jun 10, 2024)

DEnsure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0756 · Deficient, Provider has date of correction (Jun 30, 2024)

DEnsure each resident’s drug regimen must be free from unnecessary drugs.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0757 · Deficient, Provider has date of correction (Jun 30, 2024)

DProvide routine and 24-hour emergency dental care for each resident.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0790 · Deficient, Provider has date of correction (Jun 30, 2024)

DDevelop and implement policies and procedures for flu and pneumonia vaccinations.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0883 · Deficient, Provider has date of correction (Jun 30, 2024)